DEVICES FOR ACCESSING THE PERICARDIAL SPACE SURROUNDING THE HEART

• US 20100168761A1
• Filed: 03/11/2010
• Published: 07/01/2010
• Est. Priority Date: 04/27/2007
• Status: Abandoned Application

• Current Assignee: CVDEVICES, LLC
• Original Assignee: CVDEVICES, LLC
• Inventors: Navia, Jose A. SR., Kassab, Ghassan S.
• Application Number:
  US12/722,160
• Publication Number:
  US 20100168761A1
• Time in Patent Office: Days
• US Class Current: 606/129
• CPC Class Codes: A61B 17/0057 Implements for plugging an opening in the wall of a hollow or tubular organ, e.g. for sealing a vessel puncture or closing a cardiac septal defect sutures A61B17/04; closing rectum or urethra near body surface A61F2/0009
• CPC Class Codes: A61B 2017/00247 Making holes in the wall of the heart, e.g. laser Myocardial revascularization
• CPC Class Codes: A61B 2017/003 Steerable
• CPC Class Codes: A61B 2017/00584 Clips
• CPC Class Codes: A61B 2017/00592 Elastic or resilient implements
• CPC Class Codes: A61B 2017/00601 Implements entirely comprised between the two sides of the opening
• CPC Class Codes: A61B 2017/00606 Implements H-shaped in cross-section, i.e. with occluders on both sides of the opening
• CPC Class Codes: A61B 2017/00628 T-shaped occluders
• CPC Class Codes: A61B 2017/306 holding by means of suction
• CPC Class Codes: A61B 2017/308 with suction cups
• CPC Class Codes: A61B 2018/00392 Transmyocardial revascularisation
• CPC Class Codes: A61B 90/37 Surgical systems with images on a monitor during operation
• CPC Class Codes: A61M 2025/0036 with more than four lumina
• CPC Class Codes: A61M 2025/0039 characterized by lumina being arranged coaxially
• CPC Class Codes: A61M 2025/004 characterized by lumina being arranged circumferentially
• CPC Class Codes: A61M 2025/0089 Single injection needle protruding axially, i.e. along the longitudinal axis of the catheter, from the distal tip
• CPC Class Codes: A61M 2025/0096 being laterally outward extensions or tools, e.g. hooks or fibres
• CPC Class Codes: A61M 2025/015 Details of the distal fixation of the movable mechanical means
• CPC Class Codes: A61M 2025/0681 Systems with catheter and outer tubing, e.g. sheath, sleeve or guide tube
• CPC Class Codes: A61M 2205/32 with radio-opaque indicia
• CPC Class Codes: A61M 2205/33 : Controlling, regulating or measuring
• CPC Class Codes: A61M 2205/3303 : Using a biosensor
• CPC Class Codes: A61M 2205/3331 : Pressure; Flow
• CPC Class Codes: A61M 2210/122 : Pericardium
• CPC Class Codes: A61M 2210/125 : Heart
• CPC Class Codes: A61M 2230/005 : Parameter used as control input for the apparatus
• CPC Class Codes: A61M 25/00 : Catheters; Hollow probes dilators A61M29/00; peritoneal catheters A61M1/285; tracheal tubes A61M16/04; for drainage A61M27/00; for uterus, vagina or rectum A61M31/00 ; for measuring or testing A61B; materials for catheters A61L29/00
• CPC Class Codes: A61M 25/003 : characterized by features relating to least one lumen located at the distal part of the catheter, e.g. filters, plugs or valves catheter tips A61M25/0067
• CPC Class Codes: A61M 25/0054 : with regions for increasing flexibility
• CPC Class Codes: A61M 25/0074 : Dynamic characteristics of the catheter tip, e.g. openable, closable, expandable or deformable
• CPC Class Codes: A61M 25/0084 : being one or more injection needles
• CPC Class Codes: A61M 25/0136 : Handles therefor
• CPC Class Codes: A61M 25/0141 : having flexible regions as a result of using materials with different mechanical properties
• CPC Class Codes: A61M 25/0147 : with movable mechanical means, e.g. pull wires
• CPC Class Codes: A61M 25/06 : Body-piercing guide needles or the like
• CPC Class Codes: A61M 60/191 : mechanically acting upon the outside of the patient's native heart, e.g. compressive structures placed around the heart
• CPC Class Codes: A61M 60/289 : Devices for mechanical circulatory actuation assisting the residual heart function by means mechanically acting upon the patient's native heart or blood vessel structure, e.g. direct cardiac compression [DCC] devices
• CPC Class Codes: A61M 60/468 : the force acting on the actuation means being hydraulic or pneumatic
• CPC Class Codes: A61M 60/508 : Electronic control means, e.g. for feedback regulation
• CPC Class Codes: A61M 60/865 : Devices for guiding or inserting pumps or pumping devices into the patient's body
• CPC Class Codes: A61N 1/0587 : Epicardial electrode systems; Endocardial electrodes piercing the pericardium

Abstract

Devices for accessing the pericardial space surrounding the heart. In at least one embodiment of a delivery catheter for use in accessing a pericardial space surrounding the external surface of a heart, the delivery catheter comprises comprising an elongated tube comprising a wall extending from a proximal end of the tube to a distal end of the tube, a first lumen, and a steering channel extending from a proximal end of the tube to a distal end of the tube, the steering channel forming an orifice at the distal end of the tube, and a steering wire system at least partially located in the steering channel, the steering wire system comprising at least two steering wires attached to the wall of the tube within the steering channel and a controller attached to a proximal end of each of the at least two steering wires, wherein the first lumen extends from approximately the proximal end of the tube to or near the distal end of the tube, the first lumen having a bend, relative to the tube, at or near the distal end of the tube and an outlet through the wall of the tube at or near the distal end of the tube.

Claims

1. A delivery catheter for use in accessing a pericardial space surrounding the external surface of a heart, comprising:

an elongated tube comprising a wall extending from a proximal end of the tube to a distal end of the tube, a first lumen, and a steering channel extending from a proximal end of the tube to a distal end of the tube, the steering channel forming an orifice at the distal end of the tube; and

a steering wire system at least partially located in the steering channel, the steering wire system comprising at least two steering wires attached to the wall of the tube within the steering channel and a controller attached to a proximal end of each of the at least two steering wires;

wherein the first lumen extends from approximately the proximal end of the tube to or near the distal end of the tube, the first lumen having a bend, relative to the tube, at or near the distal end of the tube and an outlet through the wall of the tube at or near the distal end of the tube.

2. The delivery catheter of claim 1, wherein:

the steering channel of the tube and the orifice of the tube are sized for insertion over an elongated guide wire such that the elongated guide wire is inserted through the orifice and into the steering channel.

3. The delivery catheter of claim 1, further comprising:

a pacing lead sized for delivery through the outlet of the first lumen.

4. The delivery catheter of claim 1, wherein:

the at least two steering wires comprise a first steering wire and a second steering wire; and

the controller of the steering wire system comprises a first handle attached to the proximal end of the first steering wire and a second handle attached to the proximal end of the second steering wire.

5. The delivery catheter of claim 1, wherein:

the at least two steering wires comprise a first steering wire and a second steering wire; and

the controller of the steering wire System comprises a torque system having a first rotatable spool capable of collecting and dispensing the first steering wire and a second rotatable spool capable of collecting and dispensing the second steering wire.

6. The delivery catheter of claim 5, wherein:

the first rotatable spool is attached to a first rotatable dial such that rotation of the first rotatable dial causes rotation of the first rotatable spool; and

the second rotatable spool is attached to a second rotatable dial such that rotation of the second rotatable dial causes rotation of the second rotatable spool.

7. The delivery catheter of claim 1, wherein:

each of the at least two steering wires is attached to the wall of the tube within the steering channel at the distal end of the tube.

8. The delivery catheter of claim 1, wherein:

the bend of the first lumen forms an angle that is approximately 90-degrees.

9. The delivery catheter of claim 8, further comprising:

a pacing lead having a tip, the pacing lead positioned at least partially within the first lumen.

10. The delivery catheter of claim 9, wherein:

the tip of the pacing lead has a substantially screw-like shape.

11. The delivery catheter of claim 10, further comprising:

a sensing lead positioned at least partially within the first lumen.

12. The delivery catheter of claim 9, further comprising:

a second lumen extending from approximately the proximal end of the tube to or near the distal end of the tube, the second lumen having a bend at or near the distal end of the tube and an outlet through the wall of the tube at or near the distal end of the tube.

13. The delivery catheter of claim 12, wherein:

the bend of the second lumen forms an angle that is approximately 90-degrees.

14. The delivery catheter of claim 13, further comprising:

a micro-camera system positioned at least partially within the second lumen.

15. The delivery catheter of claim 13, further comprising:

a laser Doppler tip positioned at least partially within the second lumen.

16. The delivery catheter of claim 5, wherein:

the tube further comprises a handle at or near the proximal end of the tube; and

the controller of the steering wire system is attached to the handle.

17. A delivery catheter for use in accessing a pericardial space surrounding the external surface of a heart, comprising:

an elongated tube comprising;

a wall extending from a proximal end of the tube to a distal end of the tube,

a first lumen extending from approximately the proximal end of the tube to or near the distal end of the tube, the first lumen having a bend, relative to the tube, at or near the distal end of the tube and an outlet through the wall of the tube at or near the distal end of the tube, and

a steering channel extending from a proximal end of the tube to a distal end of the tube, the steering channel forming an orifice at the distal end of the tube; and

a steering wire system at least partially located in the steering channel, the steering wire system comprising;

a first steering wire attached to the wall of the tube within the steering channel at the distal end of the tube, the attachment between the first steering wire and the wall forming a first attachment point,

a second steering wire attached to the wall of the tube within the steering channel at the distal end of the tube, the attachment between the second steering wire and the wall forming a second attachment point,

a third steering wire is attached to the wall of the tube within the steering channel at the distal end of the tube, the attachment between the third steering wire and the wall forming a third attachment point, wherein the third attachment point is closer to the proximal end of the tube than is the first attachment point or the second attachment point, and

a controller attached to a proximal end of each of the first steering wire, the second steering wire, and the third steering wire.

18. A delivery catheter for use in accessing a pericardial space surrounding the external surface of a heart, comprising:

an elongated tube comprising a wall extending from a proximal end of the tube to a distal end of the tube, a first lumen, and a second lumen;

wherein the first lumen extends from approximately the proximal end of the tube to or near the distal end of the tube, the first lumen having a bend, relative to the tube, at or near the distal end of the tube and an outlet through the wall of the tube at or near the distal end of the tube; and

wherein the second lumen extends from approximately the proximal end of the tube to or near the distal end of the tube, the second lumen having a bend, relative to the tube, at or near the distal end of the tube and an outlet through the wall of the tube at or near the distal end of the tube.

19. The catheter of claim 18, wherein:

the bend of the first lumen forms an angle that is approximately 90-degrees.

20. The catheter of claim 19, wherein:

the bend of the second lumen forms an angle that is approximately 90-degrees.

21. The catheter of claim 18, further comprising:

a laser Doppler tip positioned at least partially within the second lumen.

22. The catheter of claim 21, further comprising:

a needle positioned at least partially within the first lumen.